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Implant Threads (implant + threads)
Selected AbstractsAugmentation of Exposed Implant Threads with Autogenous Bone Chips: Prospective Clinical StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2000Göran Widmark DDS ABSTRACT Background: Autogenous bone chips can be harvested during drilling of implant sites and may be used as a graft material for bone augmentation and coverage of exposed implant threads. Purpose: The aim of this prospective study was to evaluate the possibility of augmenting exposed implant threads with autogenous bone chips. Materials and Methods: Twenty-one consecutive patients treated with screw-shaped oral implants with exposed threads due to buccal fenestration or marginal defects were augmented with autogenous bone harvested with a bone trap during drilling of the implant site. Both marginal (9 sites) and fenestration defects (12 sites), with 4 to 14 exposed implant threads, were registered clinically and with photography. The number of exposed implant threads was measured before and at second-stage surgery 6 months after augmentation. Results: Complete bone coverage of the exposed implant threads was seen in 12 of the 21 implant sites. Six sites showed one to two remaining exposed threads, two showed about 40% coverage, and one showed flattening of the defect but with eight of nine exposed threads at 6 months follow-up. The mean bone gain was 81% in patients with a marginal defect and 82% in patients with a fenestration defect. Conclusion: The results from this clinical study show that it is possible to gain bone over exposed implant threads by augmentation with autogenous bone chips. Conclusion It is concluded that it is possible to achieve coverage of exposed implant threads by augmentation with autogenous bone chips harvested during drilling of implant sites. [source] Bone formation at recombinant human bone morphogenetic protein-2-coated titanium implants in the posterior maxilla (Type IV bone) in non-human primatesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2008Ulf M. E. Wikesjö Abstract Background: Studies using ectopic rodent and orthotopic canine models (Type II bone) have shown that titanium porous oxide (TPO) surface implants adsorbed with recombinant human bone morphogenetic protein-2 (rhBMP-2) induce local bone formation including osseointegration. The objective of this study was to evaluate local bone formation and osseointegration at such implants placed into Type IV bone. Material and Methods: rhBMP-2-coated implants were installed into the edentulated posterior maxilla in eight young adult Cynomolgus monkeys: four animals each received three TPO implants adsorbed with rhBMP-2 (2.0 mg/ml) and four animals each received three TPO implants adsorbed with rhBMP-2 (0.2 mg/ml). Contra-lateral jaw quadrants received three TPO implants without rhBMP-2 (control). Treatments were alternated between left and right jaw quadrants. Mucosal flaps were advanced and sutured to submerge the implants. The animals received fluorescent bone markers at weeks 2, 3, 4, and at week 16 when they were euthanized for histologic analysis. Results: Clinical healing was uneventful. Extensive local bone formation was observed in animals receiving implants adsorbed with rhBMP-2 (2.0 mg/ml). The newly formed bone exhibited a specific pinpoint bone,implant contact pattern regardless of rhBMP-2 concentration resulting in significant osseointegration; rhBMP-2 (2.0 mg/ml): 43% and rhBMP-2 (0.2 mg/ml): 37%. Control implants exhibited a thin layer of bone covering a relatively larger portion of the implant threads. Thus, TPO control implants bone exhibited significantly greater bone,implant contact (,75%; p<0.05). There were no statistically significant differences between rhBMP-2-coated and control implants relative to any other parameter including peri-implant and intra-thread bone density. Conclusion: rhBMP-2-coated TPO implants enhanced/accelerated local bone formation in Type IV bone in a dose-dependent fashion in non-human primates resulting in significant osseointegration. rhBMP-2-induced de novo bone formation did not reach the level of osseointegration observed in native resident bone within the 16-week interval. [source] Bone Reformation and Implant Integration following Maxillary Sinus Membrane Elevation: An Experimental Study in PrimatesCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006Vinicius C Palma DDS ABSTRACT Background:, Recent clinical studies have described maxillary sinus floor augmentation by simply elevating the maxillary sinus membrane without the use of adjunctive grafting materials. Purpose:, This experimental study aimed at comparing the histologic outcomes of sinus membrane elevation and simultaneous placement of implants with and without adjunctive autogenous bone grafts. The purpose was also to investigate the role played by the implant surface in osseointegration under such circumstances. Materials and Methods:, Four tufted capuchin primates had all upper premolars and the first molar extracted bilaterally. Four months later, the animals underwent maxillary sinus membrane elevation surgery using a replaceable bone window technique. The schneiderian membrane was kept elevated by insertion of two implants (turned and oxidized, Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) in both sinuses. The right sinus was left with no additional treatment, whereas the left sinus was filled with autogenous bone graft. Implant stability was assessed through resonance frequency analysis (OsstellTM, Integration Diagnostics AB, Göteborg, Sweden) at installation and at sacrifice. The pattern of bone formation in the experimental sites and related to the different implant surfaces was investigated using fluorochromes. The animals were sacrificed 6 months after the maxillary sinus floor augmentation procedure for histology and histomorphometry (bone-implant contact, bone area in threads, and bone area in rectangle). Results:, The results showed no differences between membrane-elevated and grafted sites regarding implant stability, bone-implant contacts, and bone area within and outside implant threads. The oxidized implants exhibited improved integration compared with turned ones as higher values of bone-implant contact and bone area within threads were observed. Conclusions:, The amount of augmented bone tissue in the maxillary sinus after sinus membrane elevation with or without adjunctive autogenous bone grafts does not differ after 6 months of healing. New bone is frequently deposited in contact with the schneiderian membrane in coagulum-alone sites, indicating the osteoinductive potential of the membrane. Oxidized implants show a stronger bone tissue response than turned implants in sinus floor augmentation procedures. [source] Effects of Implant Design and Surface on Bone Regeneration and Implant Stability: An Experimental Study in the Dog MandibleCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2001Lars Rasmusson DMD ABSTRACT Background: Previous experimental studies have shown a higher degree of bone-implant contact for surface-enlarged implants compared with machined implants. Yet, there is insufficient evidence that such implants show higher stability and an increased survival rate. Purpose: The purpose of this investigation was to study the integration and stability of grit-blasted implants with retention elements on the implant neck, with and without marginal bone defects, compared with machined implants without retention elements. Materials and Methods: After tooth extraction of the mandibular premolars in six dogs, two grit-blasted, partly microthreaded Astra Tech implants and one standard Branemark implant were bilaterally placed in each dog. On one side, 3 ± 3 mm large buccal defects were created, to expose three to four implant threads. The contralateral side served as control, and no defects were made. The animals were sacrificed after 4 months of healing. Implant stability was measured using resonance frequency analysis at implant installation and after 4 months of healing. Histologic and histomorpho-metric evaluation was made after 4 months of healing. Results: Resonance frequency analysis indicated that all implants in the test and control groups were osseointegrated after 4 months, with a tendency toward higher implant stability for the Astra Tech implants. There was a statistically significant higher increase in resonance frequency for the Astra test implants compared with their corresponding controls. Histology and histomorphometry showed well-integrated implants with varying degrees of bone repair at the defect sites. The greater bone-implant contact for the Astra implants was statistically significant. No significant difference between the implants in amount of bone filling the threads was recorded. Conclusions: The Astra Tech implants tested showed a higher degree of bone,implant contact and higher level of bone regenerated at defect sites compared with the Brånemark implants. Resonance frequency analysis demonstrated a significantly higher increase in the Astra test implants compared with their control groups than did the Brånemark test implants versus their controls. [source] Augmentation of Exposed Implant Threads with Autogenous Bone Chips: Prospective Clinical StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2000Göran Widmark DDS ABSTRACT Background: Autogenous bone chips can be harvested during drilling of implant sites and may be used as a graft material for bone augmentation and coverage of exposed implant threads. Purpose: The aim of this prospective study was to evaluate the possibility of augmenting exposed implant threads with autogenous bone chips. Materials and Methods: Twenty-one consecutive patients treated with screw-shaped oral implants with exposed threads due to buccal fenestration or marginal defects were augmented with autogenous bone harvested with a bone trap during drilling of the implant site. Both marginal (9 sites) and fenestration defects (12 sites), with 4 to 14 exposed implant threads, were registered clinically and with photography. The number of exposed implant threads was measured before and at second-stage surgery 6 months after augmentation. Results: Complete bone coverage of the exposed implant threads was seen in 12 of the 21 implant sites. Six sites showed one to two remaining exposed threads, two showed about 40% coverage, and one showed flattening of the defect but with eight of nine exposed threads at 6 months follow-up. The mean bone gain was 81% in patients with a marginal defect and 82% in patients with a fenestration defect. Conclusion: The results from this clinical study show that it is possible to gain bone over exposed implant threads by augmentation with autogenous bone chips. Conclusion It is concluded that it is possible to achieve coverage of exposed implant threads by augmentation with autogenous bone chips harvested during drilling of implant sites. [source] Bone Response to Implant-Supported Frameworks with Differing Degrees of Misfit Preload: In Vivo Study in RabbitsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2000Torsten Jemt DDS ABSTRACT Purpose: To study the bone response around implants placed in tibia of rabbits that supported misfitting superstructures secured with different degrees of preload. Materials and Methods: Twelve rabbits were provided with two terminal 10-mm and one intermediate 7-mm-long implant in each tibia. After an integration time of about 9 weeks, nine of the animals received one control framework each (n = 9), designed with good fit to all three implants. In the other tibia of these animals, and in both tibias in the remaining three rabbits, test frameworks (n = 15) were connected with a vertical misfit of about 1 mm to the intermediate implant. The intermediate set screws were tightened with a torque ranging from 15 Ncm to 26 Ncm in the different test frameworks. The fascia and skin was then sutured back over the implants. After a loading period of 2 to 3 weeks, the animals were sacrificed, and histomorphometric measurements were made and correlated to the different levels of preload of the central implant. Results: The mean bone-to-metal contact for the three best consecutive threads of the central implant was 40% for both test and control sites (p > .05). Compared to the other regions of the implant thread, less bone-to-metal contact was found at the tip of the test implant threads in the low preload group (p < .05). However, the same relation was not observed in the high preload group. A significant correlation was observed between increasing degree of preload in the central screw joint and increasing bone-to-metal contact, most obviously noticed at the tip of the implant thread (p < .01). Conclusions: Misfit stress levels of clinical magnitudes do not seem to jeopardize osseointegration per se. On the contrary, clinical levels of preload stress seem to significantly promote bone remodeling at the tip of the implant thread. [source] The impact of nicotine on bone healing and osseointegrationCLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2005An experimental study in rabbits Abstract Objectives: To examine the short-term effect of nicotine on bone healing and osseointegration. Material and methods: Sixteen female rabbits were divided into two groups. The test group was exposed to nicotine tartrate for 8 weeks and the control group was exposed to placebo. Nicotine or placebo was administered via a miniosmotic pump and plasma cotinine levels were measured weekly. The pump delivered 15 mg of nicotine/day for the animals in the test group. All rabbits had three tibial bone preparations. In the proximal and distal bone bed, implants were placed after 4 weeks (right tibia) and after 6 weeks (left tibia). Thus, 2- and 4-week healing groups were created. Removal torque test (RMT) was performed at the distal implants. Ground sections were made from the proximal and the central bone beds. The fraction of mineralized bone in contact to the implant (BIC) and the bone density within the implant threads (BD-i) were determined for the bone,implant specimens. For the central bone beds without implants the bone density (BD-c) in the bone defects was determined. Results: No significant difference in RMT values was found between the test and the control group. Histomorphometric measurements of the BIC and the peri-implant BD-i showed no significant differences between the test and the control group after 2 or 4 weeks. Significant differences were, however, found between the 2- and 4-week samples. In the central bone beds, there was no significant difference in BD-c between the test and the control group. Conclusion: Nicotine exposure in a short period of time did not have a significant impact on bone healing or implant osseointegration in rabbits. Résumé Le but de l'étude a été d'examiner l'effet à court terme de la nicotine sur la guérison osseuse et l'ostéoïntégration. Seize lapines ont été réparties en deux groupes. Le groupe test était exposé au tartrate de nicotine durant huit semaines et le groupe contrôle était exposé au placebo. La nicotine et le placebo étaient administrés par une pompe miniosmotique et les teneurs de cotinine plasmatique étaient mesurées chaque semaine. La pompe distillait 15 mg de nicotine par jour pour les animaux du groupe test. Toutes les lapines avaient trois préparations osseuses. Dans le lit osseux proximal et distal, les implants étaient placés après quatre semaines (tibia droit) et six semaines (tibia gauche) Des groupes de guérison de deux et de quatre semaines ont ainsi été créés. Des tests de torsion à l'enlèvement ont été effectués au niveau des implants distaux. Des coupes ont été effectuées pour les lits osseux centraux et proximaux. La fraction d'os minéralisé en contact avec l'implant et la densité osseuse à l'intérieur des filetages ont été déterminées pour les spécimens os/implants. Pour les lits osseux centraux sans implant la quantité osseuse dans les lésions osseuses a été déterminée. Aucune différence significative dans les valeurs de torsion à l'enlèvement n'a été trouvée entre les deux groupes. Les mesures histomorphométriques du contact os/implant et la densité osseuse à l'intérieur des filetages paroïmplantaires ne montraient aucune différence entre les deux groupes ni après deux ni après quatre semaines. Cependant des différences significatives ont été trouvées entre les échantillons à deux et quatre semaines. Dans les lits osseux centraux il n'y avait pas de différence significative de densité osseuse entre le groupe test et le contrôle. L'exposition à la nicotine durant une brève période n'avait pas d'impact significatif sur la guérison osseuse ni sur l'ostéoïntégration d'implants chez les lapines. Zusammenfassung Ziele: Den frühen Einfluss von Nikotin auf die Knochenheilung und Osseointegration zu untersuchen. Material und Methoden: 16 weibliche Kaninchen wurden in zwei Gruppe eingeteilt. Der Testgruppe wurde während 8 Wochen Nikotintartrat gegeben und die Kontrollgruppe bekam ein Placebo. Das Nikotin oder das Placebo wurde mittels einer miniosmotischen Pumpe verabreicht und man bestimmte wöchentlich die Kotininspiegel im Plasma. Bei den Tieren der Testgruppe lieferte die Pumpe 15 mg Nikotin pro Tag. Bei allen Tieren wurden 3 Stellen des Tibiaknochens bearbeitet. In das proximale und distale Knochenbett wurden nach 4 Wochen (rechte Tibia) und nach 6 Wochen (linke Tibia) Implantate eingesetzt. So wurden Gruppen mit einer Heilungszeit von 2 und 4 Wochen kreiert. Bei den distalen Implantaten wurden Ausdrehmoment-Tests (RMT) durchgeführt. Von den zentralen und proximalen Knochenbetten wurden Schliffpräparate angefertigt. Bei den Präparaten mit Implantaten und Knochen bestimmte man den Anteil an mineralisiertem Knochen in Kontakt mit dem Implantat (BIC) und die Knochendichte innerhalb der Gewindegänge (BD-i). Bei den zentralen Knochenbetten ohne Implantate bestimmte man die Knochendichte (BD-c) innerhalb der Knochendefekte. Resutate: Bei den RMT-Werten konnten zwischen der Test- und Kontrollgruppe keine signifikanten Unterschiede gefunden werden. Die histomorphometrischen Messungen des BIC und der periimplantären BD-i zeigten nach 2 oder 4 Wochen keine signifikanten Unterschiede zwischen der Test- und Kontrollgruppe. Jedoch konnten signifikante Unterschiede zwischen den Präparaten nach 2 und 4 Wochen gefunden werden. Bei den zentralen Knochenbetten bestand kein signifikanter Unterschied im BD-c zwischen der Test- und Kontrollgruppe. Schlussfolgerung: Die Verabreichung von Nikotin über einen kurzen Zeitraum hatte keinen signifikanten Einfluss auf die Knochenheilung und Osseointegration bei Kaninchen. Resumen Objetivos: Examinar los efectos a corto plazo de la nicotina en la cicatrización ósea y la osteointegración. Material y Métodos: Se dividieron 16 conejos hembras en dos grupos. El grupo de prueba fue expuesto a tartrato de nicotina durante 8 semanas y el grupo de control fue expuesto a un placebo. La nicotina o el placebo se administraron por medio de una bomba miniosmótica y se midieron e los niveles de nicotina semanalmente. La bomba suministró 15 mg de nicotina/día a los animales del grupo de prueba. Todos los conejos se sometieron a 3 preparaciones tibiales. En los lechos óseos proximales y distales, se colocaron implantes tras 4 semanas (tibia derecha) y 6 semanas (tibia izquierda). Creándose por lo tanto, dos grupos de cicatrización de 2 y 4 semanas. Se llevó a cabo un test de torque de remoción (RMT) en los implantes distales. Se realizaron cortes histológicos de los lechos óseos proximales y centrales. Se determinó la fracción de hueso mineralizado en contacto con el implante (BIC) y la densidad ósea entre las roscas (BD-i) para los especímenes de hueso-implante. Se determinó la densidad ósea (BD-c) en los defectos para los lechos óseos centrales sin implantes. Resultados: No se encontraron diferencias significativas en los valores RMT entre los grupos de prueba y de control. Las mediciones histomorfométricas del BIC y del BD-i periimplantario no mostraron diferencias significativas entre los grupos de prueba y de control tras 2 o tras 4 semanas. De todos modos se encontraron diferencias significativas entre las muestras de 2 y 4 semanas. En los lechos óseos centrales no hubo diferencias significativas en BD-c entre los grupos de prueba y de control. Conclusión: La exposición a la nicotina durante un corto periodo de tiempo no tuvo un impacto significativo en la cicatrización ósea o en la osteointegración implantaria en los conejos. [source] Bone formation at titanium porous oxide (TiUniteÔ) oral implants in type IV boneCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005Yi-Hao Huang Abstract Background: Several oral implant design advances have been suggested to overcome poor bone quality, an impediment for successful implant treatment. A novel titanium porous oxide (TPO) surface has been shown to offer favorable results in several settings. The objective of this study was to evaluate the local bone formation and osseointegration at TPO-modified implants in type IV bone. Method: Three TPO surface-modified implants (TiUniteÔ) were installed into the edentulated posterior maxilla in each of 8 Cynomolgus monkeys. The animals were injected with fluorescent bone labels at 2, 3, 4 and 16 weeks post-surgery and were euthanized at week 16 when block biopsies were collected for histologic analysis. Results: The predominant observation of the TPO implant surface was a thin layer of new bone covering most of the implant threads. Mean (±SE) bone,implant contact for the whole study group was 74.1±4.8%. There was a significant variability in bone,implant contact between animals (P=0.0003) and between sites of the same animal (P<0.0001). The variance in bone,implant contact was 30% larger among sites of the same animal than between different animals (187.5 vs. 144.8, respectively). There was a small but significant difference in bone density immediately outside, compared to within the threaded area of the implants (37.1±3.2% vs. 32.1±3.2%, P<0.0001). Bone density outside the implant threads was significantly correlated (,=0.682, P<0.0001) with the bone density within thethreaded area. Bone density within the threaded area was significantly correlated (,=0.493, P=0.0002) with bone,implant contact, whereas bone density outside the implant threads did not have a significant effect (,=0.232, P=0.1). Conclusions: The results suggest that the TPO surface possesses a considerable osteoconductive potential promoting a high level of implant osseointegration in type IV bone in the posterior maxilla. Résumé Différents nouveaux modèles d'implants ont été suggéréspour tenter de compenser la mauvaise qualité osseuse qui est un problème pour le traitement implantaire à succès. Une nouvelle surface en oxyde poreux de titane (TPO) a apporté des résultats favorables en différentes occasions. L'objectif de cette étude a été d'évaluer la formation osseuse locale et l'ostéoïntégration d'implants modifiés TPO dans de l'os de qualité type IV. Trois implants dont la surface était modifiée TPO (TiUniteTM) ont été insérés dans un maxillaire édenté postérieur de huit singes cynomolgus. Les animaux ont subi des injections de marqueurs osseux par flurorescence à deux, trois, quatre et seize semaines après la chirurgie et ont été euthanasiés à la semaine 16 quand des biopsies en bloc ont été prélevées pour l'analyse histologique. L'observation prédominante de la surface implantaire TPO était une fine couche de nouvel os couvrant la plupart des filetages implantaires. La moyenne ±SE du contact os-implant pour tout le groupe étudiéétait de 74±5%. Il y avait une variation significative dans le contact os-implant entre les animaux (P<0,0003) et entre les sites d'un même animal (P<0,0001). La variance du contact os-implant était 30% plus importante parmi les sites du même animal qu'entre différents animaux (respectivement 187 et 145). Il y avait une différence significative bien que faible dans la densité osseuse immédiatement á l'extérieur comparéà l'intérieur des zones à filetage des implants (37±3% vs 32±3%, P<0,0001). La densité osseuse en dehors des filetages implantaires était en corrélation significative (ß=0,682, P<0,0001) avec la densité osseuse à l'intérieur des zones de filetage. La densité osseuse à l'intérieur des zones de filetage était en corrélation significative (ß=0,493, P<0,0002) avec le contact os-implant, tandis que la densité osseuse en dehors des filetages implantaires n'avait pas d'effet significatif (ß=0,232, P=0,1). Ces résultats suggèrent que la surface TPO possède un potentiel ostéoconducteur considérable qui peut promouvoir une ostéoïntégration implantaire de haut niveau dans l'os de type IV dans la région maxillaire postérieure. Zusammenfassung Ziel: Um trotz schlechter Knochenqualität die Aussicht auf eine erfolgreiche implantologische Behandlung zu verbessern, wurden verschiedene Entwicklungen des Designs von Zahnimplantaten vorgeschlagen. Bei verschiedenen Gelegenheiten hat eine neue poröse Titanoxidoberfläche (TPO) scheinbar vorteilhafte Resultate gezeigt. Das Ziel dieser Studie war, die lokale Knochenbildung und die Osseointegration von Implantaten mit einer TPO-modifizierten Oberfläche im Typ IV Knochen zu untersuchen. Methode: In die zahnlosen posterioren Oberkiefern eines jeden von 8 Cynomolgus-Affen implantierte man drei Implantate mit einer TPO-modifizierten Oberfläche (TiUnite®). Den Tieren wurden 2, 3, 4 und 16 Wochen nach dem chirurgischen Eingriff fluoreszierende Knochenmarker injiziert und in der Wochen 16 wurden sie eingeschläfert und für die histologische Analyse Blockbiopsien entnommen. Resultate: Die wichtigste Beobachtung bei der TPO-Implantatoberfläche war eine dünne Schicht neuen Knochens, welche die meisten Schraubenwindungen des Implantates bedeckte. Der mittlere Knochen-Implantatkontakt (±SE) betrug in der ganzen Testgruppe 74.1±4.8%. Man fand eine signifikante Variabilität des Knochen-Implantatkontaktes unterhalb der Tiere (P=0.0003) und auch unterhalb der verschiedenen Impantate desselben Tieres (P<0.0001). Innerhalb der Implantate desselben Tieres war die Varianz des Knochen-Implantatkontaktes bis zu 30% grösser, als zwischen den verschiedenen Tieren (187.5 gegenüber 144.8). Man fand auch einen kleinen, aber signifikanten Unterschied der Knochendichte im Bereich direkt ausserhalb der Schraubenwindungen, verglichen mit dem inneren Bereich (37.1±3.2% gegenüber 32.1±3.2%, P<0.0001). Diese beiden Knochendichten waren aber signifikant miteinander korreliert (0.682, P<0.0001). Die Knochendichte innerhalb der Schraubenwindungen korrelierte signifikant mit dem Knochen-Implantat-Kontakt (ß=0.493, P=0.0002), währenddem die Knochendichte ausserhalb des Bereiches der Schraubenwindungen in dieser Beziehung keine signifikante Korrelation aufwies (ß=0.232, P=0.1). Zusammenfassung: Die Resultate lassen vermuten, dass die TPO-Oberfläche eine beachtliche osteokonduktive Fähigkeit hat, die im posterioren Oberkieferbereich mit Typ IV Knochen zu einer sehr guten Osseointegration führt. Resumen Antecedentes: Se han sugerido varios avances en los diseños de los implantes orales para superar una baja calidad de hueso, un impedimento para un tratamiento exitoso de implantes. Se ha presentado una nueva superficie de óxido de titanio poroso (TPO) que ofrece resultados favorables en diversas situaciones. El objetivo de este estudio fue evaluar la formación local de hueso y la osteointegración en implantes TPO modificados en hueso tipo IV. Método: Se instalaron tres implantes (TiUniteTM) con superficie modificada TPO en el maxilar posterior edéntulo en 8 monos Cynomolgus. Los animales fueron inyectados con marcadores óseos fluorescentes en la semana 2, 3, 4 y 16 tras la cirugía y se sacrificaron en la semana 16 recogiéndose biopsias en bloque para análisis histológicos. Resultados: La observación predominante de la superficie TPO del implante fue una fina capa de hueso nuevo cubriendo la mayor parte de las roscas. El contacto hueso-implante medio (±SE) para todo el grupo de estudio fue de 74.1±4.8%. Hubo una variabilidad significativa en el contacto hueso-implante entre animales (P=0.0003) y entre lugares del mismo animal (P<0.0001). La varianza en el contacto hueso-implante fue un 30% mayor entre lugares del mismo animal que entre los diferentes animales (187.5 vs. 144.8, respectivamente). Hubo una pequeña pero significativa diferencia en la densidad ósea inmediatamente por fuera comparada con el área roscada de los implantes (37.1±3.2% vs. 32.1±3.2%, P<0.0001). La densidad ósea por fuera de las roscas del implante se correlacionó significativamente (,=0.682, P<0.0001) con la densidad ósea entre las áreas de roscas. La densidad ósea entre las áreas de roscas se correlacionó significativamente (,=0.492, P<0.0002) con el contacto hueso implante, mientras que la densidad ósea por fuera de las roscas del implante no tuvo un efecto significativo (,=0.232, P=0.1). Conclusiones: Los resultados sugieren que la superficieTPOposee un considerable potencial osteoconductivo promoviendo un alto nivel de osteointegracióndel implante en hueso tipo IV en el maxilar posterior. [source] Evaluation of implants coated with rhBMP-2 using two different coating strategies: a critical-size supraalveolar peri-implant defect study in dogsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010Jaebum Lee Lee J, Decker JF, Polimeni G, Cortella CA, Rohrer MD, Wozney JM, Hall J, Susin C, Wikesjö UME. Evaluation of implants coated with rhBMP-2 using two different coating strategies: a critical-size supraalveolar peri-implant defect study in dogs. J Clin Periodontol 2010; 37: 582,590. doi: 10.1111/j.1600-051X.2010.01557.x. Abstract Background: Implants coated with recombinant human bone morphogenetic protein-2 (rhBMP-2) induce relevant bone formation but also resident bone remodelling. Objectives: To compare the effect of implants fully or partially coated with rhBMP-2 on new bone formation and resident bone remodelling. Materials and Methods: Twelve, male, adult, Hound Labrador mongrel dogs were used. Critical-size, supraalveolar, peri-implant defects received titanium porous oxide surface implants coated in their most coronal aspect with rhBMP-2 (coronal-load/six animals) or by immersion of the entire implant in an rhBMP-2 solution (soak-load/six animals) for a total of 30 ,g rhBMP-2/implant. All implants were air-dried. The animals were euthanized at 8 weeks for histometric evaluation. Results: Clinical healing was uneventful. Supraalveolar bone formation was not significantly affected by the rhBMP-2 application protocol. New bone height and area averaged (± SE) 3.4 ± 0.2 versus 3.5 ± 0.4 mm and 2.6 ± 0.4 versus 2.5 ± 0.7 mm2 for coronal-load and soak-load implants, respectively (p>0.05). The corresponding bone density and bone,implant contact (BIC) recordings averaged 38.0 ± 3.8%versus 34.4 ± 5.6% and 25.0 ± 3.8%versus 31.2 ± 3.3% (p>0.05). In contrast, resident bone remodelling was significantly influenced by the rhBMP-2 application protocol. Bone density outside the implants threads averaged 74.7 ± 3.8% and 50.8 ± 4.1% for coronal-load and soak-load implants, respectively (p<0.05); bone density within the thread area averaged 51.8 ± 1.2% and 37.8 ± 2.9%, and BIC 70.1 ± 6.7% and 43.3 ± 3.9% (p<0.05). Conclusion: Local application of rhBMP-2 appears to be a viable technology to support local bone formation and osseointegration. Coronal-load implants obviate resident bone remodelling without compromising new bone formation. [source] |